Emergency room management of conversion disorders

The authors present guidelines for diagnosing and managing conversion disorders in an emergency room setting. Assessment of the patient must be based on a careful physical and psychiatric evaluation that will identify any underlying physical illness or concurrent psychopathology. An accurate assessment is also vital to the clinician's decision about whether to use simple supportive interventions, to refer or hospitalize the patient, or to try to uncover the conflicts generating the conversion symptoms. If there are no contraindications to uncovering the conflicts, such as chronic symptomatology or a pathological family network, the clinician may use such techniques as hypnosis or a sodium amytal interview.